Management of Acute Inflammation

what are the cardinal signs of inflammation?

what are the cardinal signs of inflammation?

heat, redness, swelling, pain, loss of function

What are the primary principles when treating acute inflammation?

protection, optimal loading, ice, compression, elevation

what do modalities such as cryotherapy and electric stim do to manage inflammation?

change the pain system to create more comfort

how does ice primarily function?

by withdrawing heat from the body

decreasing tissue temp with ice __________ the inflammatory and immune processes

minimizes

application of ice _________ blood flow to the area

decreases

application of ice _________ nerve conduction velocity

slows

application of ice _________ pain threshold

increases

take care when applying ice over ________ nerves

superficial

cryotherapy ___________ force output of skeletal muscle

decreases

what is decreased with vasoconstriction due to cryotherapy?

extravasation of blood into surrounding tissues, local inflammation, edema production

what are good uses for cryotherapy?

acute/subacute inflammation, to decrease pain, to decrease muscle spasms or guarding, delayed onset muscle soreness

what are some absolute contraindications for cryotherapy?

impaired circulation, open wounds, cold urticaria, cold intolerance

what are some relative contraindications for cryotherapy?

sensory deficits, hypertension, elderly, rheumatoid conditions

what is typical dosage for cryotherapy?

10-20 minutes

how far does ice penetrate?

up to 4 cm

what should ice be combined with to optimally help control swelling?

elevation

what are the stages of cryotherapy onset

cold, pain/stinging, aching/discomfort, numbness

what should the frequency of application be for ice packs?

1-2 hrs

how much time should you apply an ice massage?

about 5 minutes

what level must tissue be elevated to so it has a full effect?

above heart level

why is compression of a site effective?

decreases inflammatory cytokines, increases capillary flow, lowers capillary leakage, limits edema diffusion

Relative contradictions for compression

uncontrolled heart disease, arterial disease, skin abnormalities, peripheral neuropathy

what are the benefits of compression with ice?

increased rate, magnitude, and depth of temp reduction and increased speed of lymph evacuation

what is the goal of protection (temporary immobilization)

minimize further tissue injury

rest should be of __________ duration and restricted to ____________ after trauma

limited, immediately

longer periods of unloading are __________ to healing tissue

harmful

what is optimal loading?

controlled mechanical stress

how should optimal loading be executed?

in a gradual progression (ex: no weight, toe touch, partial, full)

What are the goals of optimal loading?

restore motion and strength, minimize local structural+functional impairments

what are the 4 possible outcomes of tissue healing?

complete resolution (most common), abscess formation, fibrosis, chronic inflammation

What key points should be noted during documentation?

body part, patient position, method, dosage, patient response

what are the hemodynamic effects of cryotherapy?

increased smooth muscle tone, reflexive vasoconstriction, increased blood velocity, decreased vasomotor abilities